Most Drugs Don’t Expire (and Why the Government Already Knows This)

New research from the California Poison Control System seems to confirm past studies which showed that generally most drugs can remain potent and effective well after their expiration date. The Californian researchers discovered a stash of a variety of drugs that were still sealed in their original packaging and had been stored in good conditions, many of which had been stored there since the 1960s. This vintage supply of drugs was analyzed by researchers at the University of California, San Francisco. Roy Gerona, an assistant professor at the University of California, San Francisco’s School of Medicine helped do the testing on the drugs that had been in storage. He told ProPublica and NPR that it was “very cool” to get the chance to run the tests to determine the quality of drugs which are over three decades old. Gerona was born in the Philippines and raised there during his childhood. He recalls how people there would often rely on expired drugs to treat their illnesses, and that they did not seem to experience negative side effects from consuming them.

In 1979, the United States’ Food and Drug Administration (FDA) required pharmaceutical manufacturers to label their drugs with an expiration date. The FDA requires manufacturers to do testing to determine how stable the product will remain over a certain time. To come up with an expiration date, pharmaceutical companies conduct tests which subject the drug to heat and moisture for a certain time. The pharmaceutical companies have a financial incentive to get people to buy new drugs, and not much incentive to get people to stockpile drugs for longer periods. The purpose of instating expiration dates was to force drug makers to state how long they could guarantee the quality, safety, and effectiveness of a drug. However, most drugs seem to remain potent, safe, and effective for decades after their expiration date. This FDA regulation has led to patients, hospitals, and pharmacies throwing out perfectly good drugs. Some side effects of the FDA’s expiration date requirement is that consumers end up paying higher prices and buying more drugs to replace drugs which have reached their expiration date. The government discourages consumers from using so-called “expired” medications. The research could lead to shelf life extension programs, which could save billions of dollars.

During this same time the FDA was making the expiration date requirement, the Department of Defense was trying to determine how long drugs could be stockpiled for. During the mid-1980s the FDA assisted the military in studying how long drugs retained their potency for. The research conducted at that time suggested that nearly 90% of drugs could remain potent for decades when stored properly. Since 1955 the United States military has maintained a strategic stockpile of drugs, intended to be used during an emergency. As of 1993 the Department of Defense was storing nearly 70,000 tons of opium and morphine at vaults located at Fort Knox in Kentucky, and at West Point in New York. This was intended to protect the supply of painkillers for the entire country for at least 1 year, as a safeguard against being cut off from opium supplies. By law the government morphine is not supposed to be sold, as it would hurt American pharmaceutical companies which sell the drug. However, like the gold stored at the vaults in Fort Knox and at West Point, there is no public audit or accountability to prove just how much morphine and other drugs are actually in the government’s vaults.

Some drugs which begin to significantly degrade over time are ones which contain plant materials, such as medical marijuana. THC in marijuana products can degrade to less psychoactive and non-psychoactive compounds after a single year. Opium, which contains plant fats and oils will degrade over time, and become rancid and rot. During the early 1990s the US government realized it’s opium stockpile was going to rot away if they did not act to preserve it. To do this preservation of the painkiller stockpile, the government gave a contract to NORAMCO, a pharmaceutical company that was located in Delaware, and had them convert the US military’s opium stockpile into morphine sulfate. Morphine is the primary active chemical in opium, and pure morphine has a shelf life of at least decades when stored properly. There have been many accounts of people discovering old medicine bottles containing drugs such as cocaine or morphine which were over a hundred years old, and reportedly still produced significant effects. A drug’s chemical structure, the environment it is stored in, and the age are all factors which can influence how (or if) a drug degrades.

Some of the drugs found in the cache at the California Poison Control system included pain killers, stimulants, depressants, and antihistamines. Twelve of the 14 drugs tested at the University of California, San Francisco were nearly the same exact potency as they were when they were originally manufactured. The military and FDA’s research looked at the stability of more drugs, and in 2006 another team of researchers seemed to confirm these results when they tested the stability of over 120 drugs and found most of them remained potent for long after the expiration date. So next time you find an old stash of drugs stored in a dry, cool, and dark place, you may want to reconsider throwing them out, as they could still be quite potent. A pharmacist who was consulted for this article did want to remind people that there are certain drugs which should not be used past the expiration date, those drugs include medications which need to be refrigerated, medicines with plant matter in them, and “drugs requiring preservatives like ophthalmics and injectables” because of potential bacterial contamination. “Only rarely do expired drugs decompose into something toxic, one exception is tetracycline which isn’t used much,” the anonymous pharmacist told us. With tetracycline, some doctors believe the drug degrades into something toxic which can cause health problems.